Active NPI
Jessica L Wasserman, NP
- Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1780659474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 237102
- Practice address
- Tower Medical Office BLDG
5670 Peachtree Rd Suite 1000
Atlanta, GA 30342 - Phone
- (404) 255-1930
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 237102 | MA | Primary |
Addresses
Primary practice location
Tower Medical Office BLDG
5670 Peachtree Rd Suite 1000
Atlanta, GA 30342
Mailing address
1190 Standard Dr NE
Atlanta, GA 30319-3353
Phone (508) 450-6645
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237102 | MA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1780659474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1190 STANDARD DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303193353",
"telephone_number": "508-450-6645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TOWER MEDICAL OFFICE BLDG",
"address_2": "5670 PEACHTREE RD SUITE 1000",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30342",
"telephone_number": "404-255-1930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "JESSICA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "237102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.